Hundreds of medical staff members in Vermont’s nursing homes haven’t received Covid-19 vaccines, according to a VTDigger analysis of Medicare data, even as cases are starting to reappear in such facilities — including at least one outbreak this month.
Almost eight months after vaccines became available to medical staff, the overall vaccination rate at Vermont nursing homes was 78%, as of late July. Individual nursing homes ran the gamut when it came to their clinical staff’s vaccination rates, from a high of 95% at Menig Nursing Home in Randolph to a low of 56% at St. Johnsbury Health and Rehabilitation.
The state-owned Vermont Veterans’ Home had a staff vaccination rate of roughly 65%, the data shows. Speaking at his weekly press conference on Tuesday, Gov. Phil Scott said his administration plans to impose a vaccination mandate there, as well as at the state psychiatric hospital and in the state’s correctional facilities. (Scott said he does not expect to impose such a mandate on Vermont’s other health care facilities, stressing that his administration would lead by example rather than by mandate.)
Scott said the new rules for state facilities would have “an exit ramp” for those who choose to remain unvaccinated, such as frequent testing.
Even with the high variability in clinical staff vaccination rates at these facilities, nursing homes across the state have reported few infections overall, Health Commissioner Mark Levine said during Tuesday’s press conference.
“Probably the most important take-home message is [that] the situation in nursing homes in August of 2021 is nothing like it was at any point prior in the pandemic,” Levine said. “We’re not having abundant cases at the same time.”
Nevertheless, new coronavirus cases are beginning to show up in some long-term care facilities as the highly contagious Delta variant steadily spreads throughout the state.
Data from the Vermont Department of Health shows that the variant — a strain twice as contagious as others — is already circulating in some facilities. The state has not released the names of those facilities, but staff at Elderwood at Burlington and the Vermont Veterans’ Home have said they had three cases altogether.
Vermont Department of Health data also indicates at least one long-term care facility had an outbreak in the first week of August. There are currently eight coronavirus cases among staff and residents across the state, data from the health department shows. (While the federal Medicare data covers just nursing homes, the state data includes all long-term care facilities — a broader category.)
Ben Truman, a spokesperson for the department, declined on Tuesday to specify which long-term care facilities have had cases, asserting that the low case numbers in those locations would compromise patient privacy.
The August case tally is the highest it’s been since the week of May 23, the first time the state’s long-term care facilities reported no new cases.
Pockets of unvaccinated staff exist in every nursing home that reported its rates to Medicare in July. Some of these nursing homes even had significant outbreaks early on in the pandemic, but vaccination rates among clinical staff there continue to lag.
Two staff members tested positive last week at the Vermont Veterans’ Home, according to chief operating officer Asa Morin. Medicare data shows that roughly 65% of its medical staff are vaccinated. Previous outbreaks in the facility resulted in at least one resident death.
Morin did not say whether the infected staff were vaccinated but said that subsequent testing showed no residents caught the virus.
“What we’re seeing here is pretty much reflected nationwide in nursing home settings as well,” Morin said. “We’re making every effort to make [the vaccine] available.”
Some eldercare corporations are beginning to consider universal mandates to increase rates of vaccination. Genesis HealthCare, operator of four nursing homes in Vermont and a total of 450 skilled nursing facilities across the country, has already announced that employees will have to receive their first coronavirus vaccine by Aug. 23 and a second dose by Sept. 23, or a single dose vaccine by Aug. 23.
Genesis is betting that other companies will soon follow suit, despite concerns that nursing homes, already short on staff, will lose crucial workforce if mandates are imposed.
“We believe that these vaccination requirements will become far broader, especially in health care, so employees have had to weigh that consideration as well,” said spokesperson Lori Mayer. “As a result, we hope that the ultimate staffing implications will be limited.”
Still, she said, Genesis has made “extensive contingency plans to ensure the adequate staffing of our facilities.”
Other nursing home providers are opting for incentives.
Priority Healthcare Group, a chain with six nursing homes in the state, has implemented a $50 bonus for staff who get vaccinated, according to an employee who did not want his name used because he’s prohibited from talking to the media.
A Priority spokesperson did not respond to a request for an interview.
The state veterans’ home has offered staff paid time off and rides to a nearby vaccine clinic.
“We’re slowly seeing our numbers rising over time and trying to just continue week by week getting as many people as we can to agree to the vaccination,” Morin said.
More residents than staff are vaccinated
Staff have been much slower to get vaccinated than nursing home residents, Medicare data shows.
Most nursing homes in the state saw 90% or more of their residents vaccinated by the end of July. At 88%, Bennington Health and Rehabilitation had the lowest rate of vaccinated residents, records show. And at least seven nursing homes had all their residents vaccinated at the time.
Long-term care facilities house some of the most vulnerable Vermonters and roughly half of coronavirus deaths in the state occurred there, data shows.
Levine, the state health commissioner, said that current vaccination mandate efforts will help curtail spread of coronavirus in fall and winter.
“If we mandate vaccines for who knows who tomorrow, that’s not going to matter for Delta, because the Delta cycle is still several weeks in duration,” he said. “One dose of a vaccine won't be enough. That’s really looking forward to the fall and winter, and making sure that if any of the ... these other Greek letters [variants], become a concern ... the population will already be prepared to meet them.”
